Distribution of proteinuria- and albuminuria-to-creatinine ratios in preterm newborns,Pediatric Nephrology

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Distribution of proteinuria- and albuminuria-to-creatinine ratios in preterm newborns
Pediatric Nephrology ( IF 2.6 ) Pub Date : 2021-01-04 , DOI: 10.1007/s00467-020-04838-3
Laure Ponthier _{1,

2} , Marine Trigolet ₂ , Thierry Chianea ₃ , Fabienne Mons ₂ , Catherine Yardin _{1,

4,

5} , Vincent Guigonis _{1,

2} , Chahrazed El Hamel _{1,

2}

Affiliation

Background

Urine protein assessment is important when glomerular disease or injury is suspected. Normal values of proteinuria already published for preterm newborns suffer from limitation, with small cohorts of patients. This prospective study was conducted to update the urine total protein- and albumin-to-creatinine ratio values.

Methods

Urine samples were collected from 231 preterm newborns within the first 48 h (D0–1) and/or between 72–120 h of life (D3–4). Total protein, albumin, and creatinine were measured, their distribution and upper-limit values determined.

Results

At D0–1 and D3–4, respectively, the median for the total protein-to-creatinine ratio were 80 and 107 mg/mmol (upper-limit values 223 and 289 mg/mmol) in the whole studied population, 149 and 214 mg/mmol in children born before 29 weeks of gestational age, 108 and 130 mg/mmol in those born between 29 and 33 weeks, and 61 and 93 mg/mmol in those born after 33 weeks. For the albumin-to-creatinine ratio, the median were 12 and 17 mg/mmol (upper-limit values 65 and 62 mg/mmol) in the whole studied population, 22 and 50 mg/mmol in children born before 29 weeks, 21 mg/mmol in those born between 29 and 33 weeks, and 8 and 12 mg/mmol in those born after 33 weeks. The use of nephrotoxic drugs and mechanical ventilation seems to influence proteinuria and albuminuria values.

Conclusions

We report distribution of proteinuria- and albuminuria-to-creatinine in preterm newborns, including the upper-limit values. These values should be taken into account in the detection and diagnosis of glomerular disease and/or injury in daily clinical practice.

中文翻译：

早产儿蛋白尿和白蛋白尿与肌酐比值的分布

背景

当怀疑肾小球疾病或损伤时，尿蛋白评估很重要。已经公布的早产新生儿蛋白尿的正常值受到限制，只有少数患者。这项前瞻性研究旨在更新尿总蛋白和白蛋白与肌酐的比值。

方法

在出生后 48 小时（D0-1）和/或 72-120 小时（D3-4）内从 231 名早产新生儿中收集尿液样本。测量了总蛋白、白蛋白和肌酐，确定了它们的分布和上限值。

结果

在 D0-1 和 D3-4，在整个研究人群中，总蛋白肌酐比的中位数分别为 80 和 107 mg/mmol（上限值为 223 和 289 mg/mmol），149 和 214胎龄前 29 周出生的儿童为 mg/mmol，29 至 33 周出生的儿童为 108 和 130 mg/mmol，33 周后出生的儿童为 61 和 93 mg/mmol。对于白蛋白与肌酐的比率，整个研究人群的中位数为 12 和 17 mg/mmol（上限值为 65 和 62 mg/mmol），29 周前出生的儿童中位数为 22 和 50 mg/mmol，21 29 至 33 周出生的人为 mg/mmol，33 周后出生的人为 8 和 12 mg/mmol。使用肾毒性药物和机械通气似乎会影响蛋白尿和白蛋白尿值。